Diffuse esophageal spasm guidelines for management: Difference between revisions

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Latest revision as of 16:46, 20 November 2017

 
 
Chest pain
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
• Effort induced
• Dyspnea
• Syncope
 
• Dysphagia
• Heartburn
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
ECG and other cardiac work up
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Esophageal manometry
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Diffuse esophageal spasm(DES)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Esophageal pH
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Normal
 
 
 
 
 
Abnormal
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Primary DES
 
 
 
 
 
Secondary DES
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Mild
 
Moderate/severe
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Antispasmodics
 
Medical therapy of DES
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Botox injection/esophageal dilatation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Response
 
 
 
No response
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Repeat Dilatation or Botox inj. as needed
 
 
 
 
 
Surgical consultation